Does Venlafaxine (Effexor) Cause Sexual Side Effects?

Conditions such as depression and anxiety can impact your sex life. But some treatments for these conditions, including venlafaxine (Effexor, Effexor XR), can also cause sexual side effects.

Venlafaxine is a medication your prescriber might recommend to help manage depression, anxiety, or certain types of chronic pain. Before starting venlafaxine, it’s common to wonder about your chances of experiencing sexual side effects. Here, we’ll review how likely sexual side effects are while taking venlafaxine and how to manage them if they occur.

Does venlafaxine cause sexual side effects?

Yes, venlafaxine can cause sexual side effects in both males and females. Experts believe they happen because of how venlafaxine works in the body.

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Venlafaxine is a serotonin and norepinephrine reuptake inhibitor (SNRI). It raises the levels of two chemicals in the brain: serotonin and norepinephrine. This helps improve depression and anxiety symptoms. But these chemicals also play a role in sexual function. So a change in their levels can impact how you experience sexual arousal, both physically and mentally.

Let’s review venlafaxine's sexual side effects by gender.

Sexual side effects of venlafaxine for men

Possible sexual side effects of venlafaxine in males include:

• Trouble ejaculating 

• Decreased libido (sex drive)

• Erectile dysfunction

While rare, there are also reports of pain during ejaculation while taking venlafaxine. This particular side effect seems more likely with higher venlafaxine dosages. But lowering the dosage doesn’t always help.

Sexual side effects of venlafaxine for women

Venlafaxine-related sexual side effects in females can include:

• Trouble orgasming

• Decreased libido

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In rare cases, venlafaxine may also cause vaginal dryness. This can cause pain or discomfort during sex, which may in turn lower sexual desire. But the opposite may be true if you take venlafaxine after menopause. It may actually help improve vaginal dryness and painful intercourse in this case.

How common are sexual side effects with venlafaxine?

It’s estimated that almost 25% of people taking venlafaxine experience a sexual side effect. But not everyone is comfortable reporting these symptoms to their healthcare team. So this percentage may be even higher in reality. 

Your venlafaxine dosage may contribute to your risk of experiencing a sexual side effect. Higher doses of venlafaxine may increase the risk of sexual issues. But these symptoms can happen at low doses, as well.

Keep in mind that sexual problems often go hand in hand with the conditions venlafaxine treats. So it may be difficult to tell if it’s the medication or the health condition that’s causing them. Don’t hesitate to let your prescriber know if you’re already experiencing sexual problems before starting venlafaxine. They may decide that a different medication with a lower risk of sexual side effects is a better fit for you.

Do sexual side effects from venlafaxine go away?

Sometimes, sexual side effects will go away on their own as your body adjusts to venlafaxine over the first few weeks to months of treatment. It’s also possible that sexual problems might get better as venlafaxine helps treat your underlying health condition.

But in other cases, sexual side effects may persist throughout venlafaxine treatment. If you experience this, don’t hesitate to let your prescriber know. There are several steps they can take to help — more on that later.

Is venlafaxine more likely to cause sexual side effects than other antidepressants?

Within its class, venlafaxine seems to be more likely to cause sexual side effects than other SNRIs, such as:

• Duloxetine (Cymbalta)

• Desvenlafaxine (Pristiq)

• Levomilnacipran (Fetzima)

• Milnacipran (Savella)

Outside its class, venlafaxine seems to have a similar risk of sexual side effects as many selective serotonin reuptake inhibitors (SSRIs) and tricyclic antidepressants.

But keep in mind that everyone responds differently to antidepressants. And not everyone will experience sexual side effects while taking venlafaxine. Your prescriber can help you find the best treatment option for your needs.

How can you manage sexual side effects from venlafaxine?

As mentioned, venlafaxine’s sexual side effects vary from person to person. Some may notice mild changes in their sexual function, while others may have more bothersome changes.

Your prescriber can help determine the best next steps if sexual side effects are interfering with your quality of life. Some ways to manage them include: 

• Lowering your venlafaxine dose

• Adding another medication to help counter these effects, such as sildenafil (Viagra) or flibanserin (Addyi)

• Adding a medication that may help improve sexual side effects, such as buspirone

• Switching to a medication that’s less likely to cause sexual issues, such as bupropion (Wellbutrin SR, Wellbutrin XL)

• Seeking cognitive behavioral therapy

Keep in mind that you shouldn’t stop taking venlafaxine on your own. Stopping venlafaxine suddenly can lead to withdrawal symptoms that can harm your health. If you need to stop taking venlafaxine, your prescriber can give you directions to do so safely.

When to seek emergency care for sexual side effects

Venlafaxine can cause a prolonged erection in some cases. Although this side effect is rare, it can be a serious issue. If your erection lasts longer than 4 hours, seek immediate medical care to prevent damage to your penis.

Why trust our experts?

Written by:

Emilie White, PharmD

Emilie White is a clinical pharmacist with over a decade of hospital pharmacy experience. Her professional areas of interest include critical care as well as infectious and autoimmune diseases.

Edited by:

Stacia Woodcock, PharmD

Stacia Woodcock, PharmD, is a pharmacy editor for GoodRx. She earned her Doctor of Pharmacy degree from the University of Kentucky and is licensed in New York and Massachusetts.

Reviewed by:

Patricia Weiser, PharmD

Patricia has 16 years of pharmacist experience. She previously held positions as a community pharmacist, pharmacy manager, and hospital pharmacist.

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